Audiologists counsel patients on a variety of noise-related situational topics and they do so repeatedly and repetitively.  Here are some common talking points in audiology offices, as well as a quick look at noise in the extreme.


Realistic Assessments


It’s important for people with hearing loss and hearing aids to make realistic assessments of speech-in-noise situations.  Basically, if listeners with normal hearing are shouting to hear themselves in a situation, then it’s realistic to surmise that the noise level is winning the competition and no hearing aid on earth is going to “fix” the situation.

That’s not to say that hearing aids won’t help — they’re absolutely necessary to have a fighting chance at hearing.  But, it’s also realistic for those with hearing loss and hearing aids to adopt the everyday, automatic solutions used by normal listeners in such situations:

  • They move away from the noise to a quieter place if they want to have a conversation.
  • They move closer to the speaker and watch his/her face if they can’t get away from the noise.


Hearing Aids are for All Listening Situations


Another item that bears repeated counseling is the necessity to become familiar with the “sounds of silence.”  So many hearing aid users think they only need to use their hearing aids in difficult listening situations, such as the noisy situations described above.  In the absence of insurmountable noise, some elect not to use their hearing aids in what they consider quiet situations. 

That’s a big mistake because it reduces the auditory brain’s exposure to the low-level sounds — and their absence– which surround us and contribute important information to our environments.  We’ve talked about such noises in prior posts.  


Recruitment is an Unfair Fact of Life


A third item has to do with the patient’s own hearing system.  The perceptual phenomenon known as recruitment accompanies most cochlear hearing losses. Though recruitment is complicated and poorly understood, its effects are unmistakable to those with hearing loss.  Recruitment makes it harder in general for most people with hearing loss to function happily in high noise situations.  It’s just harder and it can prove a limiting factor for people with hearing loss when they consider what to do and where to go to enjoy life. 

Basically, people with hearing loss face a potentially handicapping situation brought about by noise levels more easily tolerated by those with normal hearing. Sad to say, recruitment is discriminatory. It takes work, strategizing, and early intervention on the part of all involved — patient, family, friends, audiologist — to side-step the handicapping danger and lead a fully active life.  


Noise as a Right or an Extreme Condition


This brings us to the last point of discussion:  public awareness of noise and silence.  Everyone has probably heard or read about the woman-with-cell-phone-on-the-train who talked for 16 hours straight in a so-called “quiet car” and was finally escorted from the train by law enforcement.  The story, which happened in 2011, is now apocryphal because it raises the concept of “enforcing” quiet areas, not to mention plain old politeness.

 In 2011, New York City began enforcing the rule of silence in eight designated quiet zones in Central Park with fines of $50 to $200. Although the eight areas comprise only 5% of the 800-acre park, enforcement was highly controversial and opposed by groups such as the NYTimes, which had this to say:

“This is New York City, a very big, noisy place that should not be forced to keep quiet.”

Pickets went up protesting the “right” to make noise.  The fight continues, as evidenced by a 2016 article advising people in desperate search of peace and quiet in the city.    

Perhaps those with hearing loss and recruitment, together with their audiologists, friends, and family, should band together and picket for the “right” to silence, or at least low-level noise.  How else are people with hearing loss going to learn to use their hearing aids, train their auditory brains, have a fighting chance to hear in public places, avoid restricting their activities and becoming …. handicapped?  

Hearing impaired of the world, has the time come to unite and march against noise?

Five years ago, if hearing professionals received a nickel every time patients complained about excessive volume of TV commercials, they could’ve all retired in short order. The retirement fund kitty started to disappear back in 2012 when the US Congress reached consensus and passed the Commercial Advertisement Loudness Mitigation Act (CALM Act).  The story of that bill is that it originally came into effect after a congresswoman’s family dinner was interrupted by loud commercials on TV.

The CALM legislation went into effect in December 2012, in response to the “most commented-on issue (to the FCC) in the last 40 years.” CALM directed the  FCC to regulate TV commercials’ volume according to formulas/protocols developed by an industry report and summarized in a Best Practices quick reference guide.  CALM required that this happen within two years, allowing one year for the FCC to get going and another year for the TV providers to comply. 


How Bad Was It Then?


Prior attempts to regular TV commercials volume had failed, so the CALM Act was a milestone.  How bad was the problem?  Here’s a good quote that summed it up:

For decades, television advertisers have been one-upping each other by turning up the volume — essentially trying to shout louder than the competitors next to them. “Every day, millions of Americans are barraged with abrasively loud television commercials,” Senator Sheldon Whitehouse, Democrat of Rhode Island, said this fall, making the TV-watching process sound downright painful.

Dispensers, Audiologists and their patients recall that the TV-watching process WAS painful for those with hearing loss, even when they are fitted with appropriate amplification.  Professionals who who fit amplification had a bag of strategies  they hauled out at the fitting and follow-up appointments, including: 

  1. Keep your finger on the remote “mute” button.
  2. Record the shows and fast-forward the commercials.
  3. Subscribe to a DVR service such as TIVO.  

Many patients had their own home grown solution, namely to of split up and watch separate TVs at home.  Others adopted infra-red or Bluetooth devices to watch/listen to TV, but none of those works intelligently to “detect” commercials and turn them down/off.  Even as hearing aids became Smart, they failed to incorporate “loud ad detection” as a feature.


How Good Is It Now?


Ads are still here, they’re getting more numerous, and they’re still loud.  CALM helps, but it’s already required an upgrade.

When CALM was enacted, most TV groups declined to comment after it passed,  but one ABC spokesman (probably not from advertising) did weigh in on the side of reason:   

“Shouting usually doesn’t get your point across in discussions, in speakers at the drive-through, or in TV commercials. The key is raising the level of creativity, not the volume.” Here, here!

Practically everyone but ad men wonder why commercials are so loud in the first place.  The standard advertising rationale is that you have to grab people’s attention to push a product; hence, the louder the better.  We know of no research that proves this to be a valid rationale when it comes to sound levels. 


Despite burgeoning online viewing options since 2012, TV remains the dominant global advertising medium, accounting for 37% of all ad dollars spent in 2015.  The Wall Street Journal anticipates a 3-5% increase in TV advertising this year and PricewaterhouseCoopers projects US TV ad revenue growth from $73B in 2016 to $81.7B in 2020.   In addition to high sound volume, TV advertising is working on a different kind of volume as well.  Since 2009, the number of ads per hour has been steadily increasing.  

With that many dollars at stake, it was a sure bet that some advertisers would find a loophole.  That loophole was in CALM language, which stated that a commercial must be no louder on average than surround programming.  Loud ads could simply lower volume mid-stream to achieve the desired average loudness, thus subverting the intent of the CALM act and driving listeners from the room.  In the same vein, inserting moments of silence into ads could lower average volume and bring advertisers into CALM compliance.

Not to be outdone, the FCC issued an update to the act in June of 2014 to mitigate the effect and close the loophole. The FCC by-passed controversy and prolonged discussion by adopting the recommendation of the TV industry’s standard-setting body, the Advanced Television Systems Committee.  By report, the adopted recommendation provides a new noise calculation algorithm designed to:

“…  keep advertisers from using silence to offset excessive loudness in calculating the average volume of a commercial. It employs ‘gating’ that ‘will exclude very quiet or silent passages of a commercial when calculating the average loudness of that commercial.'”

The CALM update gave advertisers a one year window to comply.  Theoretically, all TV advertising should have met the new standard by June 14, 2015.  Have you noticed fewer complaints from patients since then?  


feature image courtesy of NBR